Provider Demographics
NPI:1356316061
Name:CARR, KEVIN D (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:D
Last Name:CARR
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1625 STRAITS TPKE
Mailing Address - Street 2:SUITE #201
Mailing Address - City:MIDDLEBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06762-1805
Mailing Address - Country:US
Mailing Address - Phone:203-573-9512
Mailing Address - Fax:203-568-2904
Practice Address - Street 1:140 GRANDVIEW AVE
Practice Address - Street 2:SUITE #101
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-2505
Practice Address - Country:US
Practice Address - Phone:203-573-7284
Practice Address - Fax:203-573-7031
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-17
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CT040559207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H82769Medicare UPIN